0669 Disruptive Nocturnal Behaviors in PTSD Patients are Associated with More Severe Psychiatric Pathology

Abstract

Abstract Introduction The similarities and differences between trauma associated sleep disorder (TASD) and REM sleep behavior disorder (RBD) are unclear. However, both REM sleep parasomnias are associated with disruptive nocturnal behaviors (DNB) that manifest as episodes of sleep-related vocalizations, and/or complex motor behaviors. Patients who have more DNB are more likely to have a higher prevalence of PTSD. Methods In a cross-sectional study, we examined the relationship between DNB severity and the severity of psychiatric symptoms in PTSD patients. 73 civilian patients with histories of complex developmental trauma (age 47.0 ±13.3 years; 89.6% female) met the DSM-5 criteria for moderate-to-severe PTSD. PTSD Checklist for DSM-5 (PCL-5) was used to obtain an index of current PTSD severity (37.41 ± 19.84; PCL-5 >30 cutoff for PTSD). DNB was defined as the sum of the two items 1f and 1g in the Pittsburgh Sleep Quality Index PTSD Addendum (PTSD-A). The participants rated how often during the past 1 month they had trouble sleeping because of the following: (PTSD-A Item1f) “Had episodes of terror or screaming during sleep without fully awakening” and (PTSD-A Item1g) “Had episodes of ‘acting out’ their dreams, such as kicking, punching, running or screaming”. We used a stepwise multiple regression analysis with DNB as the dependent variable and the variables described below as independent variables. Results We determined the following relationships: 1. PCL-5 (r=0.359, p=0.002); 2. Brief Symptom Inventory which includes Somatization (r=0.476,p< 0.001);Obsessive-compulsiveness (r=0.429, p< 0.001); Interpersonal Sensitivity (r=0.337, p=0.004); Depression (r=0.398, p< 0.001); Anxiety (r=0.449,p< 0.001); Hostility (r=0.577, p< 0.001); Phobic Anxiety (r=0.353, p=0.002); Paranoid Ideation (r=0.412, p< 0.001); and Psychoticism (r=0.414, p< 0.001); 3. Insomnia Severity Index (r=0.363, p=0.002); 4. Beck Suicide Scale or BSS (r=0.268, p=0.025); 5.Beck Anxiety Inventory (r=0.472, p< 0.001); and 6. Fear of Sleep(r=0.493,p< 0.001). Fear of Sleep Inventory (FOS) (Beta=0.442, t=4.258, p< 0.001) and Beck Scale for Suicidal Ideation (BSS) (Beta=0.300, t=2.887, p=0.005) emerged as the significant predictors of DNB. Conclusion DNB was correlated with a wide range of psychiatric pathology in PTSD. This suggests that DNB could be an integral feature of severe PTSD. To our knowledge, this has not been previously reported. Support (if any) None